• Lutte contre les cancers

  • Observation

  • Lymphome

Impact of age and socioeconomic status on treatment and survival from aggressive lymphoma: a UK population-based study of diffuse large B-cell lymphoma

Menée au Royaume-Uni auprès de 2 137 patients atteints d'un lymphome diffus à grandes cellules B (âge médian: 70, 2 ans), cette étude évalue l'impact de l'âge et du statut socio-économique sur les traitements reçus et sur la survie

Aim : To examine the influence of patient’s age and socio-economic status on treatment and outcome in diffuse large B-cell lymphoma (DLBCL); an aggressive curable cancer, with an incidence rate that increases markedly with age but varies little with socio-economic status. Methods: Set within a representative UK population of around 4 million, data are from an established patient cohort. This report includes all patients (≥18years) newly diagnosed with DLBCL 2004–2012, with follow-up to February 2015. Results : Of the 2137 patients (median age 70.2 years) diagnosed with denovo DLBCL, 1709 (80%) were treated curatively/intensively and 1161(54.3%) died during follow-up. Five-year overall and relative survival (RS) estimates were 46.2% (95% CI 44.0–48.4%) and 54.6% (52.1%-57.0%) respectively for all patients, and 58.5% (56.1–60.9%) and 67.0% (64.3–69.6%) for intensively treated patients. 96.3% of patients <55 years (366/380) and 96.4% of those with the best performance status (543/563) were treated curatively: 5-year RSs being 77.9% (73.1–82%) and 87.1% (82.5–90.6%) respectively. At the other end of the age/fitness spectrum, 33.3% of those ≥85 years (66/198) and 41.1% with the worst performance (94/225) were treated curatively: the corresponding 5-year RSs being 50.5% (27.1–69.0%) and 22.9% (14.0–33.2%). The proportion of patients whose cancer was fully staged fell with increasing age and worsening performance status. No socio-economic variations with treatment, stage at presentation or outcome were detected. Conclusions : Performance status is more discriminatory of survival than chronological age, with fitter patients benefiting from treatment across all ages. Socio-economic factors are not predictive of outcome in patients with DLBCL in the UK.

Cancer Epidemiology

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